9 November 2017
So I have a patient, he is a very sweet little boy
(Ben) with a rather sad background. He is 4 years old, and lives with his
grandparents and brother. His mom is still in the picture, and spends time with
him once every two weeks, or something crazy like that. They came for therapy
the other day, and Ben’s granny was telling me about recent developments in
this child’s life.
As a young boy, Ben grew up almost in the shadow of
his older brother. His father had developed a bond with his brother, that was
not carried over to Ben. He would praise his brother, buy him stuff, they would
do things together, and none of this would ever happen with Ben. Ben would be
pushed around, his father would physically hurt him if he did the smallest thing
wrong, and would tell him that he is worthless and should never have been born.
His mother, it seems, was a drug addict, and also did not pay much attention to
the children and how they were being treated. Long story short, granny saw what
was happening, and had a social worker take the kids away from their parents,
to now live with their grandparents. Since then, their father has disappeared,
and is nowhere to be found, and their mother is now rehabilitating herself, and
is doing everything in her power to be a good mother and be a part of their
lives.
When Ben first arrived by me, he was extremely shy,
did not want to participate, and appeared almost afraid of disobeying his
grandmother. I would ask him questions, and his granny would repeat the
questions and tell him, rather sternly, to answer. But, we slowly made it
through the assessment, and Ben started trusting me and opening up to me more
and more. He makes eye contact, does not avoid physical touch, and follows
instructions as any 4 year old child would. He enjoys colouring in, and is
eager to learn and absorb more information. Ben is a clever little boy, and
does well with most activities presented to him.
In my professional opinion, I believe that Ben is
neurologically and physiologically fine. I do, however, believe that his
personal history with his parents has left some psychological and emotional
damage, and that this is what is causing his difficulties in expressing
himself, and to a certain extent, hampers his learning. I am not sure whether
he has ever been seen by a psychologist, but I do believe that his difficulties
are stemming from his emotional and psychological trauma as a young boy.
Ben’s granny one day asked me whether I could book
him an appointment with the paediatric neurologist, because she believes that
he is Autistic. She has done a lot of reading up on Autism, and the more she
reads, the more she is able to identify behaviours in Ben that are indicative
of Autism. At the time, I did not agree with her deductions per se, because
from what I had seen, there is not much that would indicate Autism. Sure, Ben
fixates on the number 13 when we are doing numbers, but other than that there
is not much more. He tends to isolate himself from other friends, assumingly for
fear of rejection, his emotional past, and he demonstrates difficulty with
production of various speech sounds (which has been identified as the result of
recurrent ear infection).
Once Ben had been to the paediatric neurologist,
his granny came back to me and told me that they say they do not have a
diagnosis for him. The wording they used in their letter to me was “Dear
Lauren, thank you for your referral of Ben to paeds neuro. Ben is developing
well, and shows great improvement from Speech Therapy. Please continue your
exceptional work with him”. In other words, no diagnosis. His granny was rather
distraught by this result, because she firmly believes that he has got Autism.
She then starts telling me about a series she is watching, called “Atypical”,
about a boy who has Autism, who is in high school and is trying to find love.
She says to me that all the behaviours he demonstrates are what she sees in
Ben, and she is sure he has Autism.
I am currently busy watching the series, and no
doubt that the behaviours that the actor demonstrates are those of an
individual with Autism, but I can honestly say that I do not agree with his
grandmother. I do not believe that Ben has Autism, I do believe that his
background has the biggest role to play in his current functional abilities. I
also find it rather sad that his grandmother, who spends most of her time with
him, is looking for a label to pin to her boy, so that she can blame it on
that. I will never tell her she is wrong, because as a professional I can only
tell patients what my recommendation would be, and perhaps refer them to a
psychologist, but it breaks my heart that the only way around this for her is
to label this poor boy something that he is not.
Until later…
Xoxo
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